HomeMy WebLinkAbout2016-00691 - windows CITY OF ORONO * 20 1 6 - 006 9 1
2750 KELLEY PARKWAY DATE ISSUED: 06/16/2016
ORONO,MN 55356-
" (952)249-4600 FAX: (952) 249-4616
ADDRESS : 180 ORONO ORCHARD RD S
PIN : 02-117-23-21-0010
LEGAL DESC : ORONO ORCHARDS
: LOT 050 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : 0/S BUILDING-UNDEFINED
VALUATION : $ 2,917.00
NOTE: WINDOW REPLACEMENT IN EXISTING OPENING
APPLICANT PERMIT FEE SCHEDULE 92.89
SCHERER BROS LUMBER STATE SURCHARGE(VALUATION) 1.46
10751 EXCELSIOR BLVD TOTAL 94.35
HOPKINS,MN 55343 Payment(s)
(952)277-1600 CREDIT CARD 3281 94.35
Minnesota State License#: BUIL-BC239369
OWNER
ROKKE,JOSEPH&MARSHA
180 ORONO ORCHARD RD S
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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Applicant Permitee Signature Date Issued By Signattfte Date
Jun. 15. 2016 2: 15PM No. 2722 P. 4
r ' City of Orono
Building Permit Application for Maintenance/ Replacement/ Remodel RpsidOntiai"QNLY
(i.e. g EXPANSION)
•
•
windows, doors, siding, re-roof, etc.—NO STRUCTURAL
Mailing Address: Permit number2 %i
----'44‘ixit0 - . .
"l`Q{V POBox66 �
Crystal Bay,MN 55323 0066 hale rece• ive r /4/j.
Street Address: 'Receive by
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2750 Kelley Parkway Plan reQieW foe +,,..,
G Orono,MN 55356 k ' 5
��AE o�� Total Fee
Main: 952-249-4600 FaX 952-249-4616 www.ci.orono.mn.us
This application form must be completed in full and all required information must be submitted.
Incomplete applications will be returned. (Please print)
GENERAL INFORMATIONI 0 r ,
Job Site Address:
Will this bo a Parade of Homes, Rernodelers S owcase Home or other Display Home? ¶Yes rYplo
• If yes,a special event permit is required with Police Department and City Council approval eo days prior to the event. Shuffle bus service will be
required unless applicant demonstrates sufficient on-site parking Is available. Non permitted events will not be allowed.
CONTRACTOR/APPLICANT I_NFORMATI II : •
Name:' Y iC r •
State License# .-• . I ' ' I. Expiration Date: 6 1 3( J 16
Lead Certification Number: h-1-2,10 ong. Expiration Date: • i a.o'
(for work on'homes that were'constructed prior to 1978
Phone: (cell) (office) 9sg 11 (0-7
Mailing Address: oil L a, Cit _i1` ,a 13
Contact Person: jail , . i , , \e• • ' Applicant is: , ontract.r I Homeowner (circle one)
Email and/or Fax: IA
G c Ayf y-rt P- SCS(1P_\/‘ .,r b �^ G '"
PROPERTY OWNER INFORMATIO •
Name: t ,I
Phone(day): a BuX . -i t
Address: A Ill 1 • • _ N_ . , i,A l_e City: Onm(,, ZIP:
Email and/or Fax: _
PROJECT INFORMATION: Overall project description:WI LaCtik 1 U' v 'o\ j V1 4 v"\o. () �' 1 l�
Type of Project: Any earth movement may also equt i
MCWD review&permits:
❑ Door(s) 0 Remodel . ❑Fire Damage
Minnehaha Creek Watershed District(MCWD)
El Re-roof,asphalt IDRepair ❑Storm Damage 9 15320 Minnetonka Blvd ,
❑Re-roof,cedar ❑Restoration ❑Water Damage Minnetonka,MN 55345
Phone: 952-471-0590
❑Re-roof,other(specify) El Siding ❑Other:(specify) Fax: 952471-0682
indow(s) 1 { .minne creek.or
Estimated Construction aluatlon of Project(excluding land) $_ (.. qL7• U • . .—
APPLICANT ACKNOWLEDGEMENT:
Agrees to provide all information required or requested by the Building Department;
• Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they are
solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative but to
reject it until it is complete;
■ Some or all of the information that you are asked to provide on this application is classified by State law as either private or
confidential. Private data is Information which generally cannot be given to the public but can be given to the subject of the data.
Confidential data is Information which generally cannot be given to either the public or the subject of the data, Our purpose and
intended use of this information is to annually update our records and records of other governmental agencies required by law. If
fou refuse to sus'I th_,infonnati'n the a•.lication ma not be issued.
Applicant's Signature: .r.. 1 Cr- 4 1 Date: C.f
IS jk .
Owner's Signature: _ • Date:
•
Last Updated:January 2015